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Cancer is the second leading cause of death in the United States. A cancer cell is genetically unstable and hence can mutate faster. They can also modify their microenvironment and escape immune surveillance. The difficulties in treating cancer are further compounded by the emergence of rapid resistance to anticancer drugs. The most common ways to attain resistance in cancer cells include alteration in drug transport and metabolism, modification of drug target, elevated DNA damage response, or...

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An Organotypic High Throughput System for Characterization of Drug Sensitivity of Primary Multiple Myeloma Cells
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Published on: July 15, 2015

Total cost comparison in relapsed/refractory multiple myeloma.

Brian Durie1, Gary Binder, Chris Pashos

  • 1Cedars-Sinai Samuel Oschin Cancer Center, Los Angeles, CA 90048, USA. bdurie@myeloma.org

Journal of Medical Economics
|January 4, 2013
PubMed
Summary

Lenalidomide plus dexamethasone (LEN/DEX) is more cost-effective than bortezomib (BORT) for relapsed/refractory multiple myeloma (rrMM). LEN/DEX offers lower total treatment costs and cost per outcome, despite similar drug expenses.

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Area of Science:

  • Oncology
  • Health Economics

Background:

  • Advances in multiple myeloma survival necessitate evaluating treatment costs.
  • Payer attention is increasingly focused on the economic impact of cancer care.

Purpose of the Study:

  • To compare the total costs of care for two guideline-recommended therapies in relapsed/refractory multiple myeloma (rrMM) from a US payer perspective.
  • To assess the cost-effectiveness of bortezomib (BORT) versus lenalidomide plus dexamethasone (LEN/DEX) in rrMM.

Main Methods:

  • An economic model was developed to estimate total costs over a 1-year period.
  • Costs included drug acquisition, medical resource utilization, and adverse event (AE) management.
  • Data were sourced from published literature, package inserts, and fee schedules; cost per outcome was based on pivotal clinical trial data.

Main Results:

  • Drug costs were comparable between BORT and LEN/DEX.
  • BORT incurred higher daily medical and AE management costs, exceeding $40 per day.
  • LEN/DEX demonstrated annual excess total cost savings of over $17,000 and was 11% lower per month without progression.

Conclusions:

  • While drug costs are similar, bortezomib (BORT) treatment for rrMM is associated with higher overall medical and AE management costs compared to lenalidomide plus dexamethasone (LEN/DEX).
  • LEN/DEX presents a cost advantage, with lower total costs and a better cost per outcome (month without disease progression).
  • Limitations include reliance on separate studies and a 1-year time frame, with potential variations in lifetime cost differences.